Pediatric Cerebrospinal Fluid Leak

  • Etiology:
    — Trauma such as base of skull fracture
    — Iatrogenic such as lumbar puncture
    — Surgery involving dura
  • Imaging:
    — Direct identification of cerebrospinal fluid collection outside of the neuraxis
    — Identification of side effects of cerebrospinal fluid leakage such as intracranial hypotension
  • DDX:
  • Complications:
  • Treatment: Surgical
  • Clinical: Presentation may include direct visualization of cerebrospinal fluid leaking (cerebrospinal fluid rhinorrhea or cerebrospinal fluid otorrhea or ppseudomeningocele) or side effects of cerebrospinal fluid leakage (intracranial hypotension or slit-like ventricles)

Radiology Cases of Cerebrospinal Fluid Leak

Radiology Cases of Cerebrospinal Fluid Leak Due to Dural Tear

MR myelogram of cerebrospinal fluid leak due to dural tear
Sagittal MR myelogram (above left) shows leakage of hyperintense cerebrospinal fluid into the soft tissues inferior to the cerebellum, which lateralizes to the left side on the coronal MR myelogram (above right). Sagittal T2 MRI without contrast of the brain (below) shows the tear in the linear hypointense dura with the hyperintense cerebrospinal fluid leaking through it just inferior to the tip of the cerebellar tonsil.